Friday, February 21, 2014

How to prevent embryo mixups in IVF

The biggest fear that IVF patients have is that the lab may mix up their embryos with some other patient's. If the embryos get mixed up , then their embryos may go to someone else ; and they will receive someone else’s. This is a valid concern, and embryo mixups have been well documented, even in the best of IVF labs.

This is an IVF clinic’s major nightmare as well, and because they are aware of this possibility, good clinics develop lots of safety checks , safeguards and processes , to prevent this from happening.

Since every patient’s embryos look like every other patient’s embryos , it’s very important that each dish is prominently identified with the name of the patient, so that the embryologist knows exactly who's embryos he is looking . This is why UK clinics use the system of witnessing, where two independent embryologist cross check and verify the name on each dish , every time it is handled.

This is also the reason why companies have come up with clever systems to allow for the automatic identification of the labels on the dishes, using RFID, to prevent errors which may occur as a result of mixups because of human error. This is also why most good clinics have a rule that only one procedure can be carried out at one time , so that one embryologist is handling only patient’s eggs or sperm or embryos at one time.

However , there are certain high-risk settings when the probability of a mixup becomes extremely high. This is especially true when many patients being treated simultaneously. This is very common in programs which batch their patients and do about 20-30 embryo transfer in 1-2 days. While these clinics take pride in being able to treat so many patients so efficiently . the truth is that when such large numbers and being processed in an assembly line setting, there’s lots of stress , and the pressure of time makes the likelihood of errors much higher.

The scope for errors goes up dramatically , because it’s hard to ensure that safety checks and processes are being properly followed when there are so many patients to treat in such a short span of time. It’s tempting to take shortcuts ! This is especially true, when doctors take more than one patient in the OT, so that there are more than 2 embryo transfer being done at the same time. This is a disaster waiting to happen !

The chances of the wrong embryo going into the wrong patient is extremely high in this setting. I have a suspicion that this may be happening inadvertently many a time, and lots of patients ( and sometimes even their IVF doctors) may be completely unaware that the baby they have given birth carries someone else’s DNA ! Fortunately , because most Indian babies look alike , most of these problems never ever come to light.

As a patient, to protect yourself from this hazard, you must insist that the clinic you go to follows the recommended safety checks ; and that only one embryo transfer is done at one time. This is important so that you can be sure that when you do get pregnant after IVF , the baby has been created with your embryos , and not with someone else's !